Hematopoietic cell transplantation-specific comorbidity index as an outcome predictor for patients with acute myeloid leukemia in first remission: combined FHCRC and MDACC experiences
Hematopoietic cell transplantation-specific comorbidity index as an outcome predictor for patients with acute myeloid leukemia in first remission: combined FHCRC and MDACC experiences
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DOI：
10.1182/blood-2007-06-096966
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发表时间：
2007-12-15
期刊：
影响因子：
20.3
通讯作者：
Storb, Rainer
中科院分区：
文献类型：
--
作者：
Sorror, Mohamed L.;Giralt, Sergio;Storb, Rainer
一种新的造血细胞移植特异性合并症指数（HCT-Cl）可有效预测在Fred哈钦森癌症研究中心（FHCRC）接受HCT的恶性血液病患者的结局。在此，我们将HCT-Cl的性能与其他2个指标进行比较，然后在诊断为单一疾病实体（首次完全缓解的急性髓性白血病）并在FHCRC或M接受移植的2组患者中测试其预测结局的能力。D.安德森癌症中心（MDACC）。与MDACC患者相比，FHCRC患者细胞遗传学不良（15% vs 36%）和HCT-Cl评分≥ 3（21% vs 58%）的频率较低。我们发现HCT-Cl在两个队列中与其他指标相比具有更高的敏感性和结局预测性。在FHCRC和MDACC患者中，HCT-Cl评分为0、1 - 2和3或更高预测非复发死亡率（NRM）相当。在多变量模型中，HCT-Cl评分与每个队列中NRM和生存期的最高风险比（HRS）相关。FHCRC和MDACC患者的2年生存率分别为71%和56%。校正包括HCT-Cl评分在内的风险因素后，未检测到生存率差异（HR：0.98，P = 0.94）。HCT-Cl是比较不同机构试验结果的敏感和信息丰富的工具。在HCT试验中纳入合并症数据提供了有价值的独立信息。
A new hematopoietic cell transplantation-specific comorbidity index (HCT-Cl) was effective in predicting outcomes among patients with hematologic malignancies who underwent HCT at Fred Hutchinson Cancer Research Center (FHCRC). Here, we compared the performance of the HCT-Cl to 2 other indices and then tested its capacity to predict outcomes among 2 cohorts of patients diagnosed with a single disease entity, acute myeloid leukemia in first complete remission, who underwent transplantation at either FHCRC or M. D. Anderson Cancer Center (MDACC). FHCRC patients less frequently had unfavorable cytogenetics (15% versus 36%) and HCT-Cl scores of 3 or more (21% versus 58%) compared with MDACC patients. We found that the HCT-Cl had higher sensitivity and outcome predictability compared with the other indices among both cohorts. HCT-Cl scores of 0, 1 to 2, and 3 or more predicted comparable nonrelapse mortality (NRM) among FHCRC and MDACC patients. In multivariate models, HCT-Cl scores were associated with the highest hazard ratios (HRS) for NRM and survival among each cohort. The 2-year survival rates among FHCRC and MDACC patients were 71% versus 56%, respectively. After adjustment for risk factors, including HCT-Cl scores, no difference in survival was detected (HR: 0.98, P = .94). The HCT-Cl is a sensitive and informative tool for comparing trial results at different institutions. Inclusion of comorbidity data in HCT trials provides valuable, independent information.